DIASTOLIC SPECTRUM OF LEFT-VENTRICULAR HYPERTROPHY - THE IMPACT OF ETIOLOGY AND CORONARY-ARTERY DISEASE ON DOPPLER TRANSMITRAL VELOCITY

Citation
T. Tavli et al., DIASTOLIC SPECTRUM OF LEFT-VENTRICULAR HYPERTROPHY - THE IMPACT OF ETIOLOGY AND CORONARY-ARTERY DISEASE ON DOPPLER TRANSMITRAL VELOCITY, Cardiology, 87(5), 1996, pp. 436-442
Citations number
39
Categorie Soggetti
Cardiac & Cardiovascular System
Journal title
ISSN journal
00086312
Volume
87
Issue
5
Year of publication
1996
Pages
436 - 442
Database
ISI
SICI code
0008-6312(1996)87:5<436:DSOLH->2.0.ZU;2-3
Abstract
Diastolic Filling of hypertrophied left ventricles has frequently been observed by Doppler methods. We hypothesized that filling characteris tics in hypertrophy vary with etiology and concurrent ischemia. For pa tients with hypertrophy, the left-ventricular ejection fraction was >0 .47 +/- 0.16, end-diastolic pressure was > 15 +/- 2 mm Hg, end-diastol ic volume index was <96 +/- 12 ml/m(2) and left-ventricular mass index was 127 +/- 7 g/m(2). Peak E (early) and peak A (late) diastolic velo cities and E-wave deceleration time, respectively, were as follows (si gnificant unless otherwise indicated): normal subjects (NS), 79 +/- 9 and 82 +/- 19 cm/s, and 151 +/- 7 ms; cardiomyopathic hypertrophy, 63 +/- 16, 83 +/- 15 (NS) and 193 +/- 63, aortic stenosis without coronar y disease, 110 +/- 10, 128 +/- 12 and 158 +/- 22 (NS); aortic stenosis with coronary disease, 57 +/- 12, 86 +/- 26 (NS) and 187 +/- 39; hype rtension without coronary disease, 107 +/- 9, 128 +/- 9 and 143 +/- 22 (NS); hypertension with coronary disease, 58 +/- 12, 84 +/- 26 (NS) a nd 189 +/- 29. Conclusions: Hypertrophied left ventricles filled with two diastolic Doppler patterns: a relaxation abnormality with low peak E and delayed deceleration in hypertrophic cardiomyopathy, and a comp liance abnormality with tall peak E and normal deceleration in pressur e overload hypertrophy. When coronary artery disease occurred with pre ssure overload hypertrophy, impaired relaxation was the dominant patte rn. Therefore, in addition to the known physiologic influences on dias tolic filling, the etiology and presence of coronary artery disease mo dulate the configuration of transmitral velocities into hypertrophied ventricles.